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Oct 14 2015   3:38PM GMT

ICD-10 transition not quite Y2K yet

Shaun Sutner Shaun Sutner Profile: Shaun Sutner

Tags:
athenahealth
ICD-10
ICD-10 implementation
ICD-9

Disaster has not yet ensued since the transition to ICD-10 on Oct. 1.

While there have been pockets of discontent, reports from the medical coding front have been largely positive about the changeover that had caused many healthcare providers fear and worry, though many also said during the run-up to ICD-10 that they were prepared.

Indeed, two major payers, Humana Inc. and UnitedHealth Group, the nation’s largest health insurer, said this week that business has been “smooth” and “normal,” Forbes Pharma and Healthcare writer Bruce Japsen reported.

“It’s been pretty smooth so far,” a Humana ICD-10 implementation specialist told Forbes in the Oct. 13 news post. “Almost everyone who is submitting claims is getting it right.”

And a UnitedHealth vice president said the giant insurer has seen only a “slight uptick” in claims denials amid normal call volumes, Forbes reported.

CNBC recently carried another good news ICD-10 story.

Meanwhile, in an interview last week with SearchHealthIT, Shivani Mishra, a senior marketing associate and ICD-10 specialist with cloud EHR and billing vendor athenahealth Inc., largely echoed the insurer representatives’ sentiments.

Mishra said the claims denial rate in the early days of the ICD-10 implementation, as monitored by athenahealth, was running at about 14%, roughly the same percentage as a few days before the changeover.

By Oct. 8, the end of the first full week of ICD-10, that rate had fallen to 8%, according to athenahealth’s real-time monitoring service on its Web site. Check out the ICD-10 performance of the company’s clients here.

“It’s not quite Y2K, but it’s still early,” Mishra said.

She was referring, of course, to the much-ballyhooed fretting over the transition of computer and timing systems when the 20th century changed to the 21st century at midnight on Dec. 31, 1999.

As everyone knows now, nearly nothing unusual, let alone horrible, happened after that transition.

On a personal note, I experienced the Y2K non-event as a newspaper reporter assigned to sit in the emergency command center in Worcester, Mass., with city officials from around 10 p.m. on Dec. 31 into the early morning of the new century.

We all were prepared for the worst, but I was forced to report — after driving around the city for a few hours around dawn — that most signs of city life were apparently completely normal. It was eerie, but welcome.

All of this is not to say that bigger problems won’t develop as  ICD-10’s profusion of about 70,00 codes — up from ICD-9’s approximately 17,00 – -and attendant increased complexity inevitably trigger rejected claims and probably reduced productivity for at least a while among some providers.

But it’s been pretty hard to find really bad ICD-10 experiences far.

Again, it’s still early.

Physicians who have ICD-10 Medicare claim problems can report them online to the American Medical Association.

3  Comments on this Post

 
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  • dring1
    I am surprised this story made it past Scott Wallask with "ICD-10" in the lead. Scott would have re-written that if it were my story. I had to click through to CNBC to discover it is a new medical coding system. You should have used that phrase in the lead since many, if not all, patients, at one time or another have had problems with reimbursements because of coding issues. I know you used "medical coding front" in second graph but I did not get the connection right away.
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  • Shaun Sutner
    Dear commenter:

    While I am grateful for your attentiveness to our content here at SearchHealthIT, I'd simply point out first that the term ICD-10 is like you saying Workday HCM without explaining what that is. I have no idea what that it is, but I kind of like it. Furthermore, sir, this is a blog, a format that allow us a few liberties, including using the first-person at times. Thanks again.

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  • dring1
    Thanks, Shaun.

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